polio
A new virus seen in some 25 Californian youths is causing alarm for its polio-like symptoms. Though poliomyelitis, to refer to it by its proper name, has been eradicated in the U.S. due to systematic vaccinations over several generations, the more debilitating form of the disease has left its mark on the collective psyche of the nation. This new syndrome, though related to the polio virus which caused so much havoc in the last century, is thus far nowhere near as devastating. Thought to be caused by an enterovirus from the same family as polio, the new Californian entrant can be compared to the feared virus in that it mimics polio symptoms in its more virulent cases.

This is cause for concern for Dr. Keith Van Haren, the neurologist treating the affected children, because the new virus shows a low likelihood of complete recovery for its victims. Van Haren, who teaches at the Stanford School of Medicine and is a practicing pediatric neurologist, says that the virus is extremely rare, though it has a very sudden onset. So far, no cases of the syndrome have been reported by the CDC in any location outside of California, though for those affected that is little comfort, as the children struggling to recover from the virus have yet to regain the full use of affected limbs and full respiratory function. Indeed, there is as yet no prognosis indicating that they may ever fully recover.

The affected youths have tested negative for polio, a virus in which one in every 200 victims were paralyzed, some to the point where they had to spend the remainder of their lives in a machine called an “iron lung” in order to continue breathing. The virus that is causing this new syndrome is from the same family as polio, however, being an enterovirus with much more severe symptoms than the related but milder hand, foot and mouth virus seen often in young children. Many researchers have likened the new syndrome to enterovirus-68, which has before now been seen mostly in children in Australia and Asia, though not all the California cases have tested positive for this virus.

The concern comes from the fact that the virus has resulted in five cases of paralysis in 25 victims, a very high percentage, and the fact that the culprit has yet to be identified without any doubt. In this way the new California virus again mimics polio, comparing positively in that polio was also originally a disease known to affect mostly children. The disease became an epidemic when it began to affect adults, due to a curious twist in cultural evolution. In the last century new hygiene and sanitation practices allowed many children to escape poliovirus infection. The downside was that without contracting the disease as children, many adults fighting poliomyelitus developed the more severe paralytic form of the disease, which for one in 500 sufferers, ended in death.

With epidemics springing up more often, and with worse symptoms, polio was once a heavy-hitter worldwide. The virus has affected populations from the dawn of time in every corner of the globe. There is evidence of polio outbreaks in Ancient Egypt and in Ancient Rome; famous Scottish author Sir Walter Scott may have been a polio survivor. Polio was medically described in 1789, and starred in its first full medical report in 1840. At this point all its symptoms began to be recorded as belonging to the same illness, allowing medical professionals to correctly label outbreaks and epidemics as the result of the same disease, despite the differences in presentation between children and adults.

iron lung ward polioIt took over 100 years for a working vaccine to be developed, beginning with the work of Maurice Brody and John Enders and ending with a working vaccine begun by Hilary Koprowski and perfected by Jonas Salk, just in time to be used in the midst of a vast polio epidemic in the U.S. in the 1950s. In the intervening decades 20,000 people a year were struck down, and those who survived were often forced to spend their remaining lives inside a rocking bed or a giant metal coffin called an iron lung, a machine which alternated a vacuum and forced air pressure around the sufferer’s body in order to keep their lungs working.

polio deformityLuckily such days are behind us. With the development of working vaccines, the treatment of symptoms after the fact can be seen as barbaric in retrospect. In the present day poliomyelitis has been eradicated in all but four countries worldwide, though other enteroviruses are still to be found in affected areas, notably in Asia. These days polio is endemic only in India, Pakistan, Afghanistan, and Nigeria, and other enteroviruses enjoy limited success in these and other areas to confuse the issue.

Further muddying the waters is the fact that many other illnesses, both viral and non-viral, can produce similar flaccid muscle paralysis, making it difficult to be sure that the cases in California are all the result of a single culprit. There is as yet no clear-cut evidence of a common cause, no certainty that enterovirus-68 is the virus causing all the symptoms in these children. The children did not test positive for other enteroviruses, such as aseptic meningitis or HFMD (hand, foot and mouth disease).

This family of viruses, though existing in multiple subcategories, are deemed ‘ubiquitous’ by doctors in that they affect everyone at some point in their lives, are transmitted by direct contact, and live in the gastrointestinal tract or in the upper respiratory tract, a reason why breathing is so often affected in enterovirus syndromes. Poliovirus and syndromes like meningitis can be tested for with a spinal cord MRI. This test confirms the likelihood that some enterovirus is to blame for the California symptoms, which like polio, do not respond to steroids or immunotherapy.

Though only two of the affected children tested positive for HEV-68, it is not a known syndrome in the United States. Between 10 and 15 million people are found to carry HEV-68 in the U.S. annually, though unlike with the California cases most of these infections cause few symptoms and only a fraction are serious enough to cause paralysis.

Van Haren has stated concerns that the reason no cases of the new virus have been reported outside of California may be because the syndrome can be mistaken for other illnesses, and may be missed as part of a larger pattern. As well, the results of Van Haren’s work is still being peer-reviewed, and so the CDC and other similar bodies have yet to come up with a cohesive reporting criteria. With today’s global travel, however, it is indeed unlikely that such a virus could exist only in one single point on earth. Until further cases are reported, though, we can hope that this new polio-mimic will remain sequestered in California, and that it will not result in any outbreaks or epidemics like the virus to which it has been compared.

By Kat Turner

Sources

USA Today
LA Times
NBC
Health Day
Medscape

2 Responses to "Polio Mimic: How the New Virus in California Compares"

  1. dayze   August 8, 2015 at 8:54 am

    This is August 8, 2015
    Quite the Odd thing.
    Last summer June of 2014, I started getting symptoms of weakness in my back thighs. They would give way for a second then catch, so I didn’t fall. I found that going DOWN stairs was a problem.
    I had been told that I was showing signs of Lupus years ago, (and I am an old Polio Victim age 3 1/2) so I just thought it was that Lupus coming on stronger now. Dizzy when I turn quickly, memory getting worse, weaker all over, not getting my breath when I go up stairs and having to stop and catch it.
    I had been loosing weight and shriveling up for over 4 years now, so my buns were gone.
    By November it was hurting my tailbone to sit down. Not enough flesh around it. By January I had to get an orthopedic pillow to allow my tailbone to poke through when I sat in a chair.

    Here is when it gets really odd.
    3 weeks ago an employee where I work started coughing and coughing constantly. He is from Mexico. He also works on the weekend serving at banquets so could catch something from anyone or give it to anyone as well. For 3 weeks now He every so often will start coughing parts of the day but not all.

    After 4 days around him I started coughing. Only SMALL Congestion in my throat, but my nose ran hot clear water constantly. Just enough congestion in my throat to tickle and make me cough. By Friday I missed work, so weak and constantly coughing. I stayed in bed night and day for the whole weekend, only to get up and eat and take a bath. My throat down low felt like it had been burned.

    After 3 days around me, my son started coughing with a bit more congestion in his throat and a lot in his nose. He said his throat hurt as well. He felt so bad he lost 3 days of work, so I opened the office for him, but because he has a new company he went back to work.
    He is still coughing and blowing his nose all these 3 weeks, his throat is still hurting.

    3 weeks ago my husband started complaining about his TAILBONE hurting, so I bought an orthopedic pillow for him to sit in. He says his tailbone hurts so bad he pinches his face up when getting out of a chair slowly. He has to use the pillow in a chair or in his car.

    Now, Last night, August 7, 2015 my son mentioned that he thought something was going around. He said that I and his dad were complaining about our tailbones hurting. He said NOW HIS TAILBONE WAS HURTING. HUMMM???

    That morning on the radio, they were talking about POST POLIO SYNDROME and then mentioned a virus that was going around WITH POLIO LIKE SYMPTOMS.

    With our symptoms:

    1. The first one (employee) was coughing only, and still coughing.

    2. With me, coughing, VERY LITTLE congestion only to tickle my throat, to make me cough constantly, but hot water running out of my nose. Weakness and sleepiness. Throat feeling like it had been burned down low in my throat.
    I took garlic that I fried, drank apple cider vinegar, ate parsley, and ate fresh Onion, which was always a tried and true items that I used in the past to get rid of congestion. It took longer to work when in the past it would work instantly. I continued to cough only from time to time a small bit for the next week.
    My Grandmother was an American Indian Medicine Woman, so My mother taught me some things.
    She pointed out one day when the dog was chewing on her young peach tree that when they get sick they will eat the young leaves and stems to help them.
    Remembering this, I went out and cut 2 stems from my peach tree, made myself some tea. It knocked it right out. I am fine now, no congestion, no coughing, no sore throat.

    3. My husband complaining for past 3 weeks of his tailbone hurting

    4. My son after 3 days around me, starting to cough with a bit more congestion in his throat, full congestion in nose, and he said his throat hurt. He also had fever for at least 2 days.
    He didn’t take the things I tried to get him to eat. (you know kids won’t listen to mom)
    He is still coughing with some congestion in his throat. He says his throat still hurts. He still has
    congestion in his nose.

    NOW HERE IS WHERE IT REALLY GETS WEIRD.
    Last night my son pointed out that he thought something was going around, that his tailbone hurt also.
    I remembered the man talking about the new virus that has Polio like symptoms.

    Could my son be right? Something is going around, the coughing, fever, congestion, tailbone hurting?
    It seems that IN EACH PERSON IT IS GETTING STRONGER AND STRONGER, WORSE AND WORSE.

    COULD I HAVE GOTTEN SOMETHING LAST YEAR AND BEEN CARRYING IT ALL THIS TIME???
    THINKING IT WAS LUPUS SYMPTOMS??? OR OLD POST POLIO SYMPTOMS.

    I am in Dallas, Texas but those around me travel from all over, since I go to Trade Shows.
    Could the employee from Mexico have been around those who had been in California and Mexico have gotten something and brought a stronger version to me and then to my son and husband?

    Reply
  2. Aj   February 24, 2014 at 10:52 pm

    What a supremely written article. This epidemic is scary and everyone should be reading this article, and paying attention. Thank you!

    Reply

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